Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2007 Nov 5;97(9):1266-70.
doi: 10.1038/sj.bjc.6604027. Epub 2007 Oct 9.

Comparison of the prognostic value of selected markers of the systemic inflammatory response in patients with colorectal cancer

E F Leitch  1 , M Chakrabarti, J E M Crozier, R F McKee, J H Anderson, P G Horgan, D C McMillan
Affiliations
Comparative Study

Comparison of the prognostic value of selected markers of the systemic inflammatory response in patients with colorectal cancer

E F Leitch et al. Br J Cancer. .

Abstract

There is increasing evidence that the presence of a systemic inflammatory response plays an important role in predicting survival in patients with colorectal cancer. However, it is not clear what components of the systemic inflammatory response best predict survival. The aim of the present study was to compare the prognostic value of an inflammation-based prognostic score (modified Glasgow Prognostic Score (Mgps) 0=C-reactive protein <10 mg l(-1), 1=C-reactive protein >10 mg l(-1), and 2=C-reactive protein >10 mg l(-1) and albumin<35 g l(-1)) with that of components of the white cell count (neutrophils, lymphocytes, monocytes and platelets using standard thresholds) in patients with colorectal cancer. Two patient groups were studied: 149 patients who underwent potentially curative resection for colorectal cancer and 84 patients who had synchronous unresectable liver metastases. In those patients who underwent potentially curative resection the minimum follow-up was 36 months and 20 patients died of their cancer. On multivariate survival analysis only TNM stage (HR 3.75, 95% CI 1.54-9.17, P=0.004), monocyte count (HR 3.79, 95% CI 1.29-11.12, P=0.015) and mGPS (HR 2.21, 95% CI 1.11-4.41, P=0.024) were independently associated with cancer-specific survival. In patients with synchronous unresectable liver metastases the minimum follow-up was 6 months and 71 patients died of their cancer. On multivariate survival analysis only single liver metastasis >5 cm (HR 1.78, 95% CI 0.99-3.21, P=0.054), extra-hepatic disease (HR 2.09, 95% CI 1.05-4.17, P=0.036), chemotherapy treatment (HR 2.40, 95% CI 1.82-3.17, P<0.001) and mGPS (HR 1.44, 95% CI 1.01-2.04, P=0.043) were independently associated with cancer-specific survival. In summary, markers of the systemic inflammatory response are associated with poor outcome in patients with either primary operable or synchronous unresectable colorectal cancer. An acute-phase protein-based prognostic score, the mGPS, appears to be a superior predictor of survival compared with the cellular components of the systemic inflammatory response.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The relationship between TNM stage (I, II, III and IV from top to bottom) and cancer-specific survival in patients with colorectal cancer.
Figure 2
Figure 2
The relationship between mGPS (0, 1 and 2 from top to bottom) and cancer-specific survival in patients with colorectal cancer.
See this image and copyright information in PMC

References

    1. Al Murri AM, Bartlett JM, Canney PA, Doughty JC, Wilson C, McMillan DC (2006) Evaluation of an inflammation-based prognostic score (GPS) in patients with metastatic breast cancer. Br J Cancer 94: 227–230 - PMC - PubMed
    1. American Joint Committee on Cancer (2002) Colon and rectum. In Greene FL, Page DL, Fleming ID, Fritz A, Balch CM, Haller DG, Morrow M (eds) AJCC Cancer Staging Manual, 6th edn, pp 113–124. New York, NY: Springer
    1. Bruckner HW, Lavin PT, Plaxe SC, Storch JA, Livstone EM (1982) Absolute granulocyte, lymphocyte, and monocyte counts. Useful determinants of prognosis for patients with metastatic cancer of the stomach. JAMA 247: 1004–1006 - PubMed
    1. Carstairs V, Morris R (1991) Deprivation and Health in Scotland. Aberdeen: University Press
    1. Crumley AB, McMillan DC, McKernan M, McDonald AC, Stuart RC (2006) Evaluation of an inflammation-based prognostic score in patients with inoperable gastro-oesophageal cancer. Br J Cancer 94: 637–641 - PMC - PubMed

Publication types